Epilepsy in Sierra Leone Handbook attempt to introduce the issues of epilepsy to health workers of all grades as well as members of the public and parents of persons with epilepsy who are interested in epilepsy. The aim is to demystify this contentious condition and give readers the basic knowledge to understand people with epilepsy and to propagate this knowledge in the health community as well as the community at large in order to reduce the widespread misconception about epilepsy. Readers must get this handbook as a reference book and may contact us via email or helpline: – +23288555333 for more...

People suffering from epilepsy in Sierra Leone face many challenging problems. The most tragic are burns often seen in women who usually cook in open fires and sustain severe burns if attacks occurs while cooking. In our sensitization activities we emphasize the importance of women with epilepsy avoid cooking in open fire of even cooking at all but the realities are such that this cannot be avoided in most cases. We then encourage them to place the fire at a height so if they fall they would not fall in the fire. Drowning accidents also occur as in many communities water is obtained from the river or stream and drowning even in shallow waters happen as the victim is denied help if in difficulties. We have also seen patients presenting with dislocated shoulder joints as a result of...

Even when people with epilepsy decide to seek medical treatment they face an uphill task. Firstly there are insufficient clinics in the country to cater for their needs. At the present time there are three clinics in the Western Area, one clinic each in Bo, Pujehun and Bonthe in the Southern Province, one in Kailahun in the Eastern Province and one in Makeni in the Northern Province. In addition there are more than a dozen outreach clinics in every district in the country. However these clinics are largely in the capital towns and cities. The outreach clinics are held monthly by a team of Community Health Officers from the Epilepsy Association of Sierra Leone that travels to the district clinics on a fixed date. Medication is provided in these clinics at minimal cost with exceptions to under-five children and...

A lot of attention is placed on education in our quest to reduce the effects of epilepsy on the individual and community. Sensitization is therefore aimed at these two target groups. The community may either support or alienate people with epilepsy depending on their beliefs and attitudes with respect to the condition. There are many who believe that epilepsy is contagious and patients must not be touched even when having an attack. Over 50% of people also believe that epilepsy is due to demons or witchcraft that can only be addressed by traditional means. EASL therefore spend a lot of time and resource trying to dispel these beliefs. Posters, radio jingles, radio discussion programs, village community meetings and talks to schools, churches, mosques are regularly carried out. Every district has an Epilepsy Support Worker who is a social worker and...

In Sierra Leone, epilepsy starts at an early age with the mean age of onset being 12 years. Many of the cases are due to birth injuries, infections in childhood particularly cerebral malaria and meningitis, febrile convulsions and trauma. As a result of the Civil war in Sierra Leone which ended in 1992, we see many cases of head injuries resulting from gun shots, shrapnel damage and machete assaults. Road traffic accidents are also common, many associated with traumatic brain injuries. Middle aged and older patients presenting with epilepsy are relatively uncommon but strokes are perhaps the leading cause in this age group. With poor investigative facilities, the majority of patients seen cannot be adequately investigated hence the cause of their epilepsy remain undiagnosed. Stroke Neurofibromatosis Falling down...

In Sierra Leone, the causes of epilepsy are misunderstood to be demonic, witchcraft or atonement for sins committed by one’s forefathers; it is further believed that people are possessed by supernatural forces which rendered them unable to control their bodily functions and that the condition is transferable through bodily contact of sputum that comes out of a person’s mouth during seizures. Over half of the Sierra Leonean population have the belief that Epilepsy is due to witchcraft or demons or both and two-third have tried traditional healing while a quarter seek faith healing. The condition is called by different names in Sierra Leone depending on the tribal origin. The Creoles call it ‘fix’, Temne call it ‘katuk’, Mende call it ‘Kpogboni’. Because the perception of witchcraft and demons as a cause of Epilepsy is common among Sierra Leoneans, the...